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“Everyone should have health insurance? I say everyone should have health care. I'm not selling insurance.”

- Dennis Kucinich

In light of the relentless corporate media coverage, I mean distortion, about private health insurance in general and “Obamacare” in particular, I thought it’d be helpful to obtain and share some context. That’s why I got in touch with Benjamin Day, Director of Organizing at Healthcare-NOW!

In addition to his work as a community activist in the Jamaica Plain neighborhood of Boston, (addressing issues like affordable housing issues and gentrification) Day has been working in the single-payer movement for the past eight years. His experience and perspective helps shed new light on a crucial issue at a crucial time.

My conversation with Ben went a little something like this…

MZ: When you hear someone characterize Obamacare as "socialism," where you begin in explaining the misconception?

BD: Well, as an advocate for single-payer health care we often hear from people who think that single-payer is socialistic -- and I think ironically Obamacare is often painted with the same brush, although neither have anything to do with socialism. Obamacare makes no fundamental changes to our current mix of public and private health insurance, and will expand enrollment in both systems. This mixed system is unsustainable since both our private and public health insurance systems have no way to control their costs, which are edging out all other private and public spending.

Every developed nation in the world except the United States has something like a single-payer system, where health insurance is publicly funded and universal, but it doesn't follow that the rest of the world is socialist. In fact, many industries in the United States are finding that they can't compete internationally since our health care costs are so much higher than those of competitors in countries with public, universal health care. So you could say, in a way, that our commercial insurance system is actually undermining capitalism in the United States.

MZ:It appears the health insurance and pharmaceutical corporations profiting off the current system are more concerned with their profits than whether or not they are undermining capitalism. With all the money they can funnel into efforts to paint all opposition as "socialism" designed to "ration," it's no surprise so many Americans willingly side with the status quo. How do you and how can more of us work to counter this conditioning and create a climate for change?

BD: The good news is that despite all of the money the industry puts into defeating and distorting public perception of even modest health reform, single-payer continues to poll with strong majorities of support almost regardless of how you word the question. Even polls asking if people want "socialized medicine" receive majority support. Only Rasmussen was able to produce a poll that didn't find a majority of Americans calling for publicly guaranteed, universal health care, but they have the academic integrity of a paper weight. So I actually don't think that the health care industry is winning the war of ideas on the ground, but they are decisively winning the legislative battle in Congress and in state legislatures across the country, which is where it matters in the end.

Because so much money is at stake in the health care industry, our task is more about creating a movement than about creating a climate. The climate is already there -- we have the most inequitable health care system in the developed world, with costs rising so rapidly they are destroying the federal budget, state budgets, municipal budgets, business budgets, and household budgets. Everyone in this country carries around horror stories about access and cost of care -- people are ready for sustainable, equitable health reform. We just don't have a functioning democracy, so you need a lot more than popular support to bring about fundamental change. You need mobilization.

MZ:Okay, before I ask you for your ideas on how to provoke such a mobilization, I think it'd be helpful to pick your brain, re: talking points. How do you reply to someone who says something like this: "We can't let the government run health care. We'll end up with rationing like they do in Canada. I read where someone had to wait eight months to have surgery up there. Our system has its problems but it's still better than socialized medicine."

BD: We've all had bad experiences with government management, perhaps in the education system or public services, and we've all had bad experiences with corporate management, dealing with insurance companies or looking at the financial collapse that put us into the current recession. I don't have a particular ideology about whether government or markets work better in every circumstance, but when it comes to health insurance there is overwhelming evidence that government does it better. People covered by Medicare -- our public, universal plan for seniors and those with certain disabilities -- report better access to care, better financial protection, and higher satisfaction than private health insurance. Medicare is also cheaper, and wastes less on bureaucracy, particularly the portion of Medicare run exclusively by the federal government.

Every health care system rations care -- in the United States employers decide who gets insurance coverage at all, and private insurance companies also ration through denial of claims, limited networks, and shifting costs onto patients. In countries with universal health care they also ration care, but according to need so that those with the most urgent conditions get treated first if there are ever limited facilities. Public health insurance is not perfect and needs to be managed well, but every scrap of evidence we have shows that even poorly-run public insurance is better for patients than well-run private coverage.

MZ:What would you like to say to those reading this interview in terms of inspiring them to get involved in the struggle for public insurance? What can each of us do and how can folks get involved with your work?

BD: This is not an impossible or even necessarily a long-term fight, so I'd encourage everyone to have hope and to act with urgency. Systemic reform always looks impossible until it becomes inevitable, which can happen quickly. This is how we got Medicare and Medicaid, and how many other movements that built from the grassroots were able to seize on historical openings and bend the arc of U.S. history towards justice. There are single-payer advocacy organizations in almost every state of the country, you can find them at healthcare-now.org and pnhp.org, and people who believe passionately that health care needs to be a right can add more to this movement than they probably know!

Mickey Z. is the author of 11 books, most recently the novel Darker Shade of Green. Until the laws are changed or the power runs out, he can be found on a couple of obscure websites called Facebook and Twitter. Anyone wishing to support his activist efforts can do so by making a donation here.